What To Do When Food Allergies Strike

Food allergy is an increasingly serious and potentially life-threatening medical condition affecting 33 million Americans. The number of allergic reactions to food has risen by almost 400% since 2008 and today, one in every 13 children has a food allergy. That’s two kids in every U.S. classroom. 

While researchers aren’t sure what’s behind the rise in food allergies, family history appears to play a role in whether someone develops a food allergy. If you have other kinds of allergic reactions, like eczema or hay fever, you have a greater risk of a food allergy. 

In the U.S., the nine most common food allergens are: milk, egg, peanut, tree nuts, soy, wheat, fish, shellfish, and sesame.

While food allergy reactions can vary unpredictably from mild to severe, they are ALL potentially life threatening.

The first symptoms of an allergic reaction usually appear between a few minutes and two hours after exposure to a food. Symptoms can affect different parts of the body, can occur alone or in combination, and can range from mild to severe or even life-threatening.

Mild symptoms include:

• Nose: itchy or runny nose, sneezing
• Mouth: itchy mouth
• Skin: a few hives, mild itch
• Gut: mild nausea or discomfort

Severe symptoms include:

• Lung: shortness of breath, wheezing, repetitive cough
• Heart: pale, blue, faint, weak pulse, dizzy
• Throat: tight, hoarse, trouble breathing/swallowing
• Mouth: significant swelling of the tongue or lips
• Skin: many hives over body, widespread redness
• Gut: repetitive vomiting or severe diarrhea
• Psychological: feeling something bad is about to happen, anxiety, confusion

Severe reactions can quickly progress to anaphylaxis, a condition that can be life-threatening. For this reason, severe reactions must be treated promptly.

WHAT TO DO FOR AN ALLERGIC REACTION:

If the symptoms are mild, give an antihistamine by mouth such as diphenhydramine (Benadryl or a store brand). 

If the symptoms are severe, use an epinephrine* autoinjector as directed right away and call 911 for emergency medical help. Lay the person flat, raise legs and keep them warm. If breathing is difficult or they are vomiting, let them sit up or have them lie on their side.

If symptoms do not improve, or symptoms return, more doses of epinephrine can be given about 5 minutes or more after the last dose.

*Epinephrine is the only medication that can reverse the symptoms of anaphylaxis. It is available in an easy-to-use auto-injector (Auvi-Q ®, EpiPen®, Generic Epinephrine Auto-Injector [Authorized Generic of EpiPen®] or Adrenaclick®). Epinephrine is a safe and relatively harmless drug. When in doubt, use it! The risks of anaphylaxis outweigh any risks from giving the medication.

If you've been prescribed an epinephrine autoinjector for an allergy, be sure you:

• Know how to use it. Also, make sure the people closest to you know how to give the drug—if they're with you in an anaphylactic emergency, they could save your life.
• Always carry it with you. It may be a good idea to keep an extra autoinjector in your car or in your desk at work.
• Keep an eye on the expiration date. Expired epinephrine may not work properly so it’s important to replace it before their expiration date.

Bentley Munsell BSN, RN, CEN Clinical Nurse Manager of ExpressCare at Southwestern Vermont Medical Center.